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Does C‐reactive protein monitoring after colorectal resection with anastomosis give any practical benefit for patients with intra‐abdominal septic complications?
Author(s) -
Mik M.,
Berut M.,
Dziki L.,
Dziki A.
Publication year - 2016
Publication title -
colorectal disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.029
H-Index - 89
eISSN - 1463-1318
pISSN - 1462-8910
DOI - 10.1111/codi.13386
Subject(s) - medicine , surgery , anastomosis , colorectal surgery , abdominal surgery , colorectal cancer , confidence interval , c reactive protein , gastroenterology , cancer , inflammation
Aim This study aimed to assess the influence of the C‐reactive protein ( CRP ) level on the early outcome after elective colorectal resection. Method Patients with colorectal cancer operated on between 2006 and 2013 were identified retrospectively. They were divided into a study group operated on between 2010 and 2013 when CRP was measured routinely on the fourth postoperative day and a control group operated on between 2006 and 2009 when the CRP level was not measured routinely. Mortality, intra‐abdominal septic complications ( IASC ), abscesses and anastomotic leakage ( AL ), the need for reoperation, the interval from index surgery to relaparotomy, length of hospital stay and imaging studies were compared by multivariate analysis. Results A total of 1189 patients were assessed, including 598 (50.3%) in the study group (mean age 61.3 ± 13 years; 282 female) and 591 (49.7%) in the control group (mean age 61.8 ± 11 years; 267 female). There were seven (1.2%) postoperative deaths in the study group and nine (1.5%) in the control group ( P = 0.598). Abdominal ultrasound ( US ) was performed more often in the study group [97 (16.2%) vs 71 (12.0%); P = 0.037]. In the study group the interval to diagnosis of IASC was shorter than in the control group (5.7 ± 1.5 days vs 7.3 ± 1.3 days; P = 0.029). The decision to reoperate was also made earlier in the study group (6.2 ± 1.7 days vs 7.4 ± 2.8 days; P = 0.043). Conclusion Routine measurement of CRP can help to make an earlier diagnosis of IASC and earlier decision for relaparotomy, without any influence on mortality or length of hospital stay.